Provider Demographics
NPI:1487807756
Name:BERGER, SUE (LPC)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:BERGER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8255 SW HUNZIKER ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-2318
Mailing Address - Country:US
Mailing Address - Phone:503-810-0227
Mailing Address - Fax:
Practice Address - Street 1:8255 SW HUNZIKER ST STE 100
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-2318
Practice Address - Country:US
Practice Address - Phone:503-810-0227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC1264101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional